{"id":44,"date":"2011-02-16T23:17:28","date_gmt":"2011-02-16T23:17:28","guid":{"rendered":"http:\/\/drnat.com\/nd\/?page_id=44"},"modified":"2021-02-26T09:58:04","modified_gmt":"2021-02-26T09:58:04","slug":"articles","status":"publish","type":"page","link":"https:\/\/drnat.com\/nd\/resources\/articles\/","title":{"rendered":"Articles"},"content":{"rendered":"
\n
\n

PRP and Spine<\/strong><\/h1>\n

1.<\/p>\n

Cita on<\/b>: Cameron JA, Thielen KM (2017) Autologous Platelet Rich Plasma for Neck and Lower Back Pain Secondary to Spinal Disc Herniation: Midterm Results. Spine Res. Vol. 3 No. 2:10<\/p>\n

Autologous Platelet Rich Plasma for Neck and Lower Back Pain Secondary to Spinal Disc Herniation: Midterm Results\u00a0<\/b><\/p>\n

Abstract\u00a0<\/b><\/p>\n

Background: <\/b>Spinal disc herniation (HNP) can be a painful condition caused by a variety of traumatic events and degenerative conditions. It is one of the most common spine conditions in adults, occurring in both cervical and lumbar regions. Although these injuries are often associated with wear and tear (or degeneration), traumatic events such as automobile accidents or lifting injuries have been described as causes.<\/p>\n

Methodology: <\/b>We conducted a prospective, nonrandomized, single-center clinical study to evaluate the safety and midterm effectiveness of autologous platelet rich plasma injections (PRP) to treat neck and Low Back Pain (LBP) caused by spinal disc herniation (HNP). All patients had failed conservative treatment for 3 months to 6 months. The autologous PRP was performed using a table top centrifuge device and a standardized individual PRP preparation protocol method. Patients were followed annually for up to 8 years post-operatively. Pain status was documented using a visual analog scale self-reported measure, as well as the Oswestry disability score.<\/p>\n

Results: <\/b>Eighty-eight consecutive patients with spinal disc herniation (HNP) were enrolled; thirty-eight were treated for cervical disc herniation, thirty-eight for lumbar disc herniation, and twelve were treated for both cervical and lumber disc herniation. The duration of follow-up ranged from 4 months to 8 years (mean of 5 years). 87% of patients reported a successful outcome. Within the cervical group, the preoperative visual analog scale showed 81% improvement (P ? 0.01). For the lumbar patients, the preoperative visual analog scale improved by 77% (P ? 0.01). No complications were reported.<\/p>\n

Conclusion: <\/b>The results are durable with successful outcomes observed 8 years after procedure.<\/p>\n

Keywords: <\/b>Platelet rich plasma; Spinal injuries; Hernia on; Lumbar; Cervical; Platelet Rich Plasma (PRP)<\/p>\n

Received: <\/b>June 23, 2017; Accepted: <\/b>July 04, 2017; Published: <\/b>July 10, 2017<\/p>\n

 <\/p>\n<\/div>\n

\n

Vol.3No.2:10<\/p>\n

Julian A Cameron* and Katelyn M Thielen<\/p>\n

Comprehensive Spine Center, PLLC 7710 NW 71 Court Suite 205 Tamarac, USA<\/p>\n

*Corresponding author: Julian A Cameron ? info@cspinecenter.com<\/p>\n

Cameron, Comprehensive Spine Center, PLLC 7710 NW 71 Court Suite 205 Tamarac, USA.<\/p>\n

Tel: (954) 747-1221<\/p>\n

Cita on: Cameron JA, Thielen KM (2017) Autologous Platelet Rich Plasma for Neck and Lower Back Pain Secondary to Spinal Disc Hernia on: Midterm Results. Spine Res. Vol. 3 No. 2:10<\/p>\n

<\/div>\n
<\/div>\n
<\/div>\n
<\/div>\n<\/div>\n<\/div>\n

PRP and KNEE<\/strong><\/h1>\n

1.<\/p>\n

Electron Physician.<\/a>\u00a02016 Mar 25;8(3):2115-22. doi: 10.19082\/2115. eCollection 2016.<\/div>\n

Efficacy of Platelet-Rich Plasma versus Hyaluronic Acid for treatment of\u00a0Knee\u00a0Osteoarthritis: A systematic review and meta-analysis.<\/h1>\n
Sadabad HN<\/a>1,\u00a0Behzadifar M<\/a>2,\u00a0Arasteh F<\/a>3,\u00a0Behzadifar M<\/a>4,\u00a0Dehghan HR<\/a>5.<\/div>\n
\n

Author information<\/a><\/h3>\n
<\/div>\n<\/div>\n
\n

Abstract<\/h3>\n
\n

INTRODUCTION:<\/h4>\n

Knee\u00a0osteoarthritis is a very common chronic degenerative disease that could impose significant costs to the health system. Although osteoarthritis can affect all joints,\u00a0knee\u00a0osteoarthritis is the most common type among adolescents. Non-surgical treatments include corticosteroids injection, hyaluronic acid, and platelet-rich plasma. The aim of this study was to investigate the efficiency of platelet-rich plasma versus hyaluronic acid for the treatment of\u00a0knee\u00a0osteoarthritis.<\/p>\n

METHODS:<\/h4>\n

Pubmed, Cochran library, Scopus and Ovid databases were investigated to identify related studies from 2000 through August 2015. To study the efficiency, Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) outcome using the Standard Mean Difference (SMD) index was calculated using a random model and a confidence interval of 95%. In addition, sensitivity and cumulative analysis were conducted. The data were analyzed using RevMan 5.3.5 and Stata 12 software.<\/p>\n

RESULTS:<\/h4>\n

Seven studies with 722 subjects (364 participants in\u00a0PRP\u00a0and 358 participants in the HA group) were analyzed. The WOMAC\u00a0PRPcompared to HA, SMD = -0.75 (95% CI: -1.33 to -0.18, I2 = 92.6%) in treatment of\u00a0knee\u00a0osteoarthritis was statistically significant and\u00a0PRP\u00a0was more effective.<\/p>\n

CONCLUSION:<\/h4>\n

The results of this meta-analysis two years after\u00a0PRP\u00a0injection showed the efficacy of\u00a0PRP\u00a0versus HA. However, further studies are required to determine the longer-term effects.<\/p>\n<\/div>\n<\/div>\n

\n

KEYWORDS:<\/h4>\n

efficacy; hyaluronic acid; meta-analysis; platelet-rich plasma<\/p>\n<\/div>\n

 <\/p>\n

2.<\/p>\n

Knee\u00a0Surg Sports Traumatol Arthrosc.<\/a>\u00a02016 Apr 16. [Epub ahead of print]<\/div>\n

Does platelet-rich plasma decrease time to return to sports in acute muscle tear? A randomized controlled trial.<\/h1>\n
Rossi LA<\/a>1,\u00a0Molina R\u00f3moli AR<\/a>2,\u00a0Bertona Altieri BA<\/a>1,\u00a0Burgos Flor JA<\/a>1,\u00a0Scordo WE<\/a>1,\u00a0Elizondo CM<\/a>1.<\/div>\n
\n

Author information<\/a><\/h3>\n
<\/div>\n<\/div>\n
\n

Abstract<\/h3>\n
\n

PURPOSE:<\/h4>\n

The aim of this study is to report the effects of autologous\u00a0PRP\u00a0injections on time to return to play and recurrence rate after acute grade 2 muscle injuries in recreational and competitive athletes.<\/p>\n

METHODS:<\/h4>\n

Seventy-five patients diagnosed with acute muscle injuries were randomly allocated to autologous\u00a0PRP\u00a0therapy combined with a rehabilitation programme or a rehabilitation programme only. The primary outcome of this study was time to return to play. In addition, changes in pain severity and recurrence rates were evaluated.<\/p>\n

RESULTS:<\/h4>\n

Patients in the\u00a0PRP\u00a0group achieved full recovery significantly earlier than controls (P\u00a0=\u00a00.001). The mean time to return to play was 21.1\u00a0\u00b1\u00a03.1\u00a0days and 25\u00a0\u00b1\u00a02.8\u00a0days for the\u00a0PRP\u00a0and control groups, respectively (P\u00a0=\u00a00.001). Significantly lower pain severity scores were observed in the\u00a0PRP\u00a0group throughout the study. The difference in the recurrence rate after 2-year-follow-up was not statistically significant between groups.<\/p>\n

CONCLUSIONS:<\/h4>\n

A single\u00a0PRP\u00a0injection combined with a rehabilitation programme significantly shortened time to return to sports compared to a rehabilitation programme only. Recurrence rate was not significantly different between groups.<\/p>\n

LEVEL OF EVIDENCE:<\/h4>\n<\/div>\n<\/div>\n
\n

KEYWORDS:<\/h4>\n

Acute muscle injuries; Platelet-rich plasma; Return to sports<\/p>\n<\/div>\n

 <\/p>\n

3<\/strong><\/p>\n

Knee\u00a0Surg Sports Traumatol Arthrosc.<\/a>\u00a02016 Apr 7. [Epub ahead of print]<\/p>\n

Choice of intra-articular injection in treatment of\u00a0knee\u00a0osteoarthritis: platelet-rich plasma, hyaluronic acid or ozone options.<\/h1>\n
Duymus TM<\/a>1,\u00a0Mutlu S<\/a>2,\u00a0Dernek B<\/a>3,\u00a0Komur B<\/a>2,\u00a0Aydogmus S<\/a>4,\u00a0Kesiktas FN<\/a>5.<\/div>\n
\n

Author information<\/a><\/h3>\n
<\/div>\n<\/div>\n
\n

Abstract<\/h3>\n
\n

PURPOSE:<\/h4>\n

This study was performed to compare the efficacy of treatment in three groups of patients with\u00a0knee\u00a0osteoarthritis (OA) given an intra-articular injection of platelet-rich plasma (PRP), hyaluronic acid (HA) or ozone gas.<\/p>\n

METHODS:<\/h4>\n

A total of 102 patients with mild-moderate and moderate\u00a0knee\u00a0OA who presented at the polyclinic with at least a 1-year history of\u00a0kneepain and VAS score ?4 were randomly separated into three groups. Group 1 (PRP\u00a0group) received intra-articular injection of\u00a0PRP\u00a0\u00d7\u00a02 doses, Group 2 (HA group) received a single dose of HA, and Group 3 (Ozone group) received ozone\u00a0\u00d7\u00a0four doses. Weight-bearing anteroposterior-lateral and Merchant’s radiographs of both knees were evaluated. WOMAC and VAS scores were applied to all patients on first presentation and at 1, 3, 6 and 12\u00a0months.<\/p>\n

RESULTS:<\/h4>\n

At the end of the 1st month after injection, significant improvements were seen in all groups. In the 3rd month, the improvements in WOMAC and VAS scores were similar in Groups 1 and 2, while those in Group 3 were lower (p\u00a0<\u00a00.001). At the 6th month, while the clinical efficacies of\u00a0PRP\u00a0and HA were similar and continued, the clinical effect of ozone had disappeared (p\u00a0<\u00a00.001). At the end of the 12th month,\u00a0PRPwas determined to be both statistically and clinically superior to HA (p\u00a0<\u00a00.001).<\/p>\n

CONCLUSION:<\/h4>\n

In the treatment of mild-moderate\u00a0knee\u00a0OA,\u00a0PRP\u00a0was more successful than HA and ozone injections, as the application alone was sufficient to provide at least 12\u00a0months of pain-free daily living activities.<\/p>\n

LEVEL OF EVIDENCE:<\/h4>\n

Therapeutic study, Level I.<\/p>\n<\/div>\n<\/div>\n

\n

KEYWORDS:<\/h4>\n

Hyaluronic acid; Intra-articular injection options;\u00a0Knee\u00a0osteoarthritis; Ozone; Platelet-rich plasma<\/p>\n

 <\/p>\n<\/div>\n

\n
J Phys Ther Sci.<\/a>\u00a02015 Dec;27(12):3863-7. doi: 10.1589\/jpts.27.3863. Epub 2015 Dec 28.<\/div>\n

Effectiveness of platelet-rich plasma in the treatment of moderate\u00a0knee\u00a0osteoarthritis: a randomized prospective study.<\/h1>\n
Kavadar G<\/a>1,\u00a0Demircioglu DT<\/a>2,\u00a0Celik MY<\/a>3,\u00a0Emre TY<\/a>4.<\/div>\n
\n

Author information<\/a><\/h3>\n
<\/div>\n<\/div>\n
\n

Abstract<\/h3>\n
\n

[Purpose] To assess the effects of different numbers of platelet-rich plasma (PRP) applications on pain and physical function in grade 3\u00a0kneeosteoarthritis (OA). [Subjects and Methods] A total of 102 patients with grade 3\u00a0knee\u00a0OA were randomly divided into three groups: Group 1 received a single injection of\u00a0PRP, Group 2 received two injections of\u00a0PRP\u00a0two weeks apart, Group 3 received three injections of\u00a0PRP\u00a0at 2-weeks intervals. All patients were evaluated with a visual analog scale (VAS), the Western Ontario and McMaster Universities Arthritis Index (WOMAC), and the Timed-Up and Go test (TUG) before the treatment and at 1, 3 and 6 months after the treatment. [Results] Ninety-eight patients (15 males, 83 females) completed the study. The mean ages of the patients were 53.5\u00b16.6, 54.9\u00b15.3, and 55.1\u00b15.6?years in Group 1, Group 2, and Group 3, respectively. Statistically significant improvements were noted in all of the evaluated measures in all of the groups. The mean differences of Group 1-Group 2 and Group 1-Group 3 WOMAC total, WOMAC pain, WOMAC stiffness, and WOMAC function scores were statistically significant. [Conclusion]\u00a0PRP\u00a0is an effective treatment for functional status and pain in moderate\u00a0knee\u00a0osteoarthritis and a minimum of two injections is appropriate.<\/p>\n<\/div>\n<\/div>\n

\n

KEYWORDS:<\/h4>\n

Knee\u00a0osteoarthritis; Moderate; Platelet-rich plasma effectiveness<\/p>\n<\/div>\n<\/div>\n

<\/div>\n
5.<\/strong><\/div>\n
Arthroscopy.<\/a> 2011 Aug 8. [Epub ahead of print]<\/div>\n

Platelet-Rich Plasma Intra-Articular Injection Versus Hyaluronic Acid Viscosupplementation as Treatments for Cartilage Pathology: From Early<\/a> Degeneration to Osteoarthritis<\/a><\/h1>\n

Kon E<\/a>,\u00a0Mandelbaum B<\/a>,\u00a0Buda R<\/a>,\u00a0Filardo G<\/a>,\u00a0Delcogliano M<\/a>,\u00a0Timoncini A<\/a>,\u00a0Fornasari PM<\/a>,\u00a0Giannini S<\/a>,\u00a0Marcacci M<\/a>.<\/p>\n

Abstract<\/h3>\n

PURPOSE:<\/h4>\n

The aim of our study is to compare the efficacy of platelet-rich plasma (PRP) and viscosupplementation (hyaluronic acid [HA]) intra-articular injections for the treatment of\u00a0knee\u00a0cartilage degenerative lesions and osteoarthritis (OA).<\/p>\n

METHODS:<\/h4>\n

The study involved 150 patients affected by cartilage degenerative lesions and early and severe\u00a0OA. Fifty symptomatic patients were treated with 3 autologous\u00a0PRP\u00a0intra-articular injections and were evaluated prospectively at enrollment and at 2- and 6-month follow-up. The results obtained were compared with 2 homogeneous groups of patients treated with HA injections. One group was treated with injections of high-molecular weight HA; the other group was treated with low-molecular weight (LW) HA. International\u00a0Knee\u00a0Documentation Committee and EQ VAS scores were used for clinical evaluation; adverse events and patient satisfaction were also recorded.<\/p>\n

RESULTS:<\/h4>\n

At 2 months’ follow-up, the\u00a0PRP\u00a0and LW HA groups showed a similar improvement, with higher results compared with the high-molecular weight HA group (P < .005). At 6 months’ follow-up, better results were observed in the\u00a0PRP\u00a0group (P < .005).\u00a0PRP\u00a0and LW HA treatments offered similar results in patients aged over 50 years and in the treatment of advanced\u00a0OA.\u00a0PRP\u00a0showed a better performance compared with HA in younger patients affected by cartilage lesions or early\u00a0OA.<\/p>\n

CONCLUSIONS:<\/h4>\n

Autologous\u00a0PRP\u00a0injections showed more and longer efficacy than HA injections in reducing pain and symptoms and recovering articular function. Better results were achieved in younger and more active patients with a low degree of cartilage degeneration, whereas a worse outcome was obtained in more degenerated joints and in older patients, in whom results similar to those of viscosupplementation have been observed.<\/p>\n

LEVEL OF EVIDENCE:<\/h4>\n

Level II, prospective comparative study.<\/p>\n

Copyright \u00a9 2011 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.<\/p>\n

 <\/p>\n

 <\/p>\n

6.<\/span><\/strong><\/p>\n

Knee\u00a0Surg Sports Traumatol Arthrosc.<\/a> 2010 Apr;18(4):472-9. Epub 2009 Oct 17.<\/p>\n

Platelet-rich plasma: intra-articular\u00a0knee\u00a0injections<\/a><\/h1>\n

produced favorable results on degenerative cartilage lesions.<\/a><\/h1>\n

Kon E<\/a>,\u00a0Buda R<\/a>,\u00a0Filardo G<\/a>,\u00a0Di Martino A<\/a>,\u00a0Timoncini A<\/a>,\u00a0Cenacchi A<\/a>,\u00a0Fornasari PM<\/a>,\u00a0Giannini S<\/a>,\u00a0Marcacci M<\/a>.<\/p>\n

Department of Orthopaedic and Sports Trauma, Rizzoli Orthopaedic Institute, Bologna, Italy.\u00a0e.kon@biomec.ior.it<\/a><\/p>\n

Abstract<\/h3>\n

Platelet-rich plasma (PRP) is a natural concentrate of autologous blood growth factors experimented in different fields of medicine in order to test its potential to enhance tissue regeneration. The aim of our study is to explore this novel approach to treat degenerative lesions of articular cartilage of the\u00a0knee. One hundred consecutive patients, affected by chronic degenerative condition of the\u00a0knee, were treated with\u00a0PRP\u00a0intra-articular injections (115 knees treated). The procedure consisted of 150-ml of venous blood collected and twice centrifugated: 3\u00a0PRP\u00a0units of 5 ml each were used for the injections. Patients were clinically prospectively evaluated before and at the end of the treatment, and at 6 and 12 months follow-up. IKDC, objective and subjective, and EQ VAS were used for clinical evaluation. Statistical analysis was performed to evaluate the significance of sex, age, grade of\u00a0OA\u00a0and BMI. A statistically significant improvement of all clinical scores was obtained from the basal evaluation to the end of the therapy and at 6-12 months follow-up (P < 0.0005). The results remained stable from the end of the therapy to 6 months follow up, whereas they became significantly worse at 12 months follow up (P = 0.02), even if still significantly higher respect to the basal level (P < 0.0005). The preliminary results indicate that the treatment with\u00a0PRP\u00a0injections is safe and has the potential to reduce pain and improve\u00a0knee\u00a0function and quality of live in younger patients with low degree of articular degeneration.<\/p>\n

7.<\/span><\/strong><\/p>\n

Clin Exp Rheumatol.<\/a> 2009 Mar-Apr;27(2):201-7<\/p>\n

Intraarticular administration of platelet-rich plasma with biodegradable gelatin hydrogel microspheres prevents osteoarthritis progression in the rabbit<\/a> knee<\/a><\/h1>\n

Abstract<\/h3>\n

OBJECTIVE:<\/h4>\n

To investigate the therapeutic potential of administration of gelatin hydrogel microspheres containing platelet-rich plasma (PRP), by examining its effects on progression of osteoarthritis (OA) in a rabbit model.<\/p>\n

METHODS:<\/h4>\n

PRP\u00a0and platelet-poor plasma (PPP) were prepared from rabbit blood. Adult rabbit chondrocytes were cultured in the alginate beads with the presence of 3%\u00a0PRP\u00a0or 3% PPP. Glycosaminoglycan (GAG) synthesis was quantified using dimethylmethylene blue assay. To confirm the anabolic effect of\u00a0PRP\u00a0in vivo, cartilage matrix gene expression was examined after intraarticular administration of\u00a0PRP\u00a0contained in gelatin hydrogel microspheres. The\u00a0PRP\u00a0contained in gelatin hydrogel microspheres was administered into the rabbit\u00a0knee joint\u00a0twice with an interval of 3 weeks, beginning 4 weeks after anterior cruciate ligament transection (ACLT). Ten weeks after ACLT, gross morphological and histological examinations were performed.<\/p>\n

RESULTS:<\/h4>\n

PRP\u00a0significantly stimulated chondrocyte GAG synthesis in vitro. In the\u00a0knee joint, expression of proteoglycan core protein mRNA in the articular cartilage increased after administration of\u00a0PRP\u00a0contained in microspheres. Intraarticular injections of\u00a0PRP\u00a0in gelatin hydrogel microspheres significantly suppressed progression of\u00a0OA\u00a0in the ACLT rabbit model morphologically and histologically.<\/p>\n

CONCLUSION:<\/h4>\n

The present findings indicate that sustained release of growth factors contained in\u00a0PRP\u00a0has preventive effects against\u00a0OA\u00a0progression. These preventive effects appear to be due to stimulation of cartilage matrix metabolism, caused by the growth factors contained in\u00a0PRP.<\/p>\n

8.<\/p>\n

J Orthop Res.<\/a> 2011 Sep;29(9):1320-6. doi: 10.1002\/jor.21384. Epub 2011 Mar 15<\/p>\n

Autologous protein solution inhibits MMP-13 production by IL-1? and TNF?-stimulated human articular chondrocytes.<\/a><\/h1>\n

Abstract<\/h3>\n

Catabolic inflammatory cytokines are prevalent in osteoarthritis (OA). The purpose of this study was to evaluate an autologous protein solution (APS) as a potential chondroprotective agent for\u00a0OA\u00a0therapy. APS was prepared from platelet-rich plasma (PRP). The APS solution contained both anabolic (bFGF, TGF-?1, TGF-?2, EGF, IGF-1, PDGF-AB, PDGF-BB, and VEGF) and anti-inflammatory (IL-1ra, sTNF-RI, sTNF-RII, IL-4, IL-10, IL-13, and IFN?) cytokines but low concentrations of catabolic cytokines (IL-1?, IL-1?, TNF?, IL-6, IL-8, IL-17, and IL-18). Human articular chondrocytes were pre-incubated with the antagonists IL-1ra, sTNF-RI, or APS prior to the addition of recombinant human IL-1? or TNF?. Following exposure to inflammatory cytokines, the levels of MMP-13 in the culture medium were evaluated by ELISA. MMP-13 production stimulated in chondrocytes by IL-1? or TNF? was reduced by rhIL-1ra and sTNF-RI to near basal levels. APS was also capable of inhibiting the production of MMP-13 induced by both IL-1? and TNF?. The combination of anabolic and anti-inflammatory cytokines in the APS created from\u00a0PRP\u00a0may render this formulation to be a potential candidate for the treatment of inflammation in patients at early stages of\u00a0OA.<\/p>\n

Copyright \u00a9 2011 Orthopaedic Research Society.<\/p>\n

9.<\/strong><\/p>\n

Am J Phys Med Rehabil.<\/a> 2012 May;91(5):411-7<\/p>\n

Treatment of\u00a0knee joint\u00a0osteoarthritis with autologous platelet-rich plasma in comparison with hyaluronic acid.<\/h1>\n

Spakov\u00e1 T<\/a>,\u00a0Rosocha J<\/a>,\u00a0Lacko M<\/a>,\u00a0Harvanov\u00e1 D<\/a>,\u00a0Gharaibeh A<\/a>.<\/p>\n

Abstract<\/h3>\n

OBJECTIVE:<\/h4>\n

This study aimed to find a simple, cost-effective, and time-efficient method for the preparation of platelet-rich plasma (PRP), so the acquired benefits will be readily available for multiple procedures in smaller outpatient clinics and to explore the safety and efficacy of the application of\u00a0PRP\u00a0in the treatment of degenerative lesions of articular cartilage of the\u00a0knee.<\/p>\n

DESIGN:<\/h4>\n

The study was designed as a prospective, cohort study with a control group. A total of 120 patients with Grade 1, 2, or 3 osteoarthritis according to the Kellgren and Lawrence grading scale were enrolled in the study. One group of patients was treated using three intra-articular applications of\u00a0PRP, and the second group of patients was given three injections of hyaluronic acid. Outcome measures included the Western Ontario and McMaster Universities Osteoarthritis Index and the 11-point pain intensity Numeric Rating Scale.<\/p>\n

RESULTS:<\/h4>\n

On average, a 4.5-fold increase in platelet concentration was obtained in the\u00a0PRP\u00a0group. No severe adverse events were observed. Statistically significantly better results in the Western Ontario and McMaster Universities Osteoarthritis Index and Numeric Rating Scale scores were recorded in a group of patients who received\u00a0PRP\u00a0injections after a 3- and 6-mo follow-up.<\/p>\n

CONCLUSIONS:<\/h4>\n

Our preliminary findings support the application of autologous\u00a0PRP\u00a0as an effective and safe method in the treatment of the initial stages of\u00a0knee\u00a0osteoarthritis. Further studies are needed to confirm these results and to investigate the persistence of the beneficial effects observed.<\/p>\n

 <\/p>\n

10.<\/p>\n

Platelet-Rich Plasma Versus Focused Shock Waves in the Treatment of Jumper\u2019s Knee in Athletes<\/h1>\n
\n
    \n
  1. Mario Vetrano<\/a>, MD*<\/a>,\u2020<\/a>,<\/li>\n
  2. Anna Castorina<\/a>, MD\u2020<\/a>,<\/li>\n
  3. Maria Chiara Vulpiani<\/a>, MD\u2020<\/a>,<\/li>\n
  4. Rossella Baldini<\/a>, PhD\u2021<\/a>,<\/li>\n
  5. Antonio Pavan<\/a>, MD\u00a7<\/a>\u00a0and<\/li>\n
  6. Andrea Ferretti<\/a>, MD?<\/a><\/li>\n<\/ol>\n

    +<\/a>Author Affiliations<\/p>\n

      \n
    1. <\/a>
      \n
      \u2020<\/sup>Physical Medicine and Rehabilitation Unit, Sant\u2019Andrea Hospital, Sapienza University of Rome, Rome, Italy<\/address>\n<\/li>\n
    2. <\/a>
      \n
      \u2021<\/sup>Department of Statistical Sciences, Sapienza University of Rome, Rome, Italy<\/address>\n<\/li>\n
    3. <\/a>
      \n
      \u00a7<\/sup>Department of Immunohematology and Transfusion, Sant\u2019Andrea Hospital, Sapienza University of Rome, Rome, Italy<\/address>\n<\/li>\n
    4. <\/a>
      \n
      ?<\/sup>Orthopaedic Unit and Kirk Kilgour Sports Injury Centre, Sant\u2019Andrea Hospital, Sapienza University of Rome, Rome, Italy<\/address>\n<\/li>\n
    5. <\/a>
      \n
      Investigation performed at the Sant\u2019Andrea Hospital, Sapienza University of Rome, Rome, Italy<\/address>\n<\/li>\n<\/ol>\n
        \n
      1. ?<\/a>*Mario Vetrano, MD, Physical Medicine and Rehabilitation Unit, Sant\u2019Andrea Hospital, Via di Grottarossa 1035-1039, Rome, Italy 00189 (email:mariovetrano@gmail.com<\/a>).<\/li>\n<\/ol>\n<\/div>\n
        \n

        Abstract<\/h2>\n
        \n

        Background:<\/strong>\u00a0Tendinopathies represent a serious challenge for orthopaedic surgeons involved in treatment of athletes.<\/p>\n<\/div>\n

        \n

        Purpose:<\/strong>\u00a0To compare the effectiveness and safety of platelet-rich plasma (PRP) injections and focused extracorporeal shock wave therapy (ESWT) in athletes with jumper\u2019s knee.<\/p>\n<\/div>\n

        \n

        Study Design:<\/strong>\u00a0Randomized controlled trial; Level of evidence, 1.<\/p>\n<\/div>\n

        \n

        Methods:<\/strong>\u00a0Forty-six consecutive athletes with jumper\u2019s knee were selected for this study and randomized into 2 treatment groups: 2 autologous PRP injections over 2 weeks under ultrasound guidance (PRP group; n = 23), and 3 sessions of focused extracorporeal shock wave therapy (2.400 impulses at 0.17-0.25 mJ\/mm2<\/sup>\u00a0per session) (ESWT group; n = 23). The outcome measures were Victorian Institute of Sports Assessment\u2013Patella (VISA-P) questionnaire, pain visual analog scale (VAS), and modified Blazina scale. A reviewer who was blinded as to the group allocation of participants performed outcome assessments before treatment and at 2, 6, and 12 months after treatment. Nonparametric tests were used for within-group (Friedman\/Wilcoxon test) and between-group (Kruskal-Wallis\/Fisher test) testing, and the significance level was set at .05.<\/p>\n<\/div>\n

        \n

        Results:<\/strong>\u00a0The 2 groups were homogeneous in terms of age, sex, level of sports participation, and pretreatment clinical status. Patients in both groups showed statistically significant improvement of symptoms at all follow-up assessments. The VISA-P, VAS, and modified Blazina scale scores showed no significant differences between groups at 2-month follow-up (P<\/em>\u00a0= .635, .360, and .339, respectively). The PRP group showed significantly better improvement than the ESWT group in VISA-P, VAS scores at 6- and 12-month follow-up, and modified Blazina scale score at 12-month follow-up (P<\/em>\u00a0< .05 for all).<\/p>\n<\/div>\n

        \n

        Conclusion:<\/strong>\u00a0Therapeutic injections of PRP lead to better midterm clinical results compared with focused ESWT in the treatment of jumper\u2019s knee in athletes.<\/p>\n

        11.<\/div>\n
        \n
        \n
        \n
        \n
        \n
        \n
        \n

        Effectivenness of PRP on Pain, Function and Quality of Life in Chondromalacia and Patellofemoral<\/h1>\n

        Pain Syndrome: A Pretest-Postest Analysis<\/p>\n

        Olga Susana P\u00e9rez Moro1, Mar\u00eda Jes\u00fas Albaladejo Flor\u00edn1, Beatriz Entrambasaguas Estepa2 and Marcos Edgar Fern\u00e1ndez Cuadros1,3<\/p>\n

        Tel:<\/p>\n<\/div>\n<\/div>\n

        \"page1image6168\"<\/p>\n

        \n
        \n

        1Rehabilitation Department, Santa Cristina ?s University Hospital, Spain 2Rehabilitation Department, La Princesa University Hospital, Spain
        \n3Rehabilitation Department, Sant\u00edsima Trinidad General Foundation ?s Hospital, Spain Submission: April 28, 2017; Published: May 30, 2017<\/p>\n<\/div>\n<\/div>\n

        \n
        \n

        *Corresponding author: Marcos E Fern\u00c3\u00a1ndez-Cuadro<\/p>\n<\/div>\n<\/div>\n<\/div>\n

        Abstract<\/p>\n<\/div>\n<\/div>\n

        \n
        \n

        Patellofemoral Pain Syndrome (PFPS) and Chondromalacia.<\/p>\n<\/div>\n<\/div>\n

        \n
        \n

        b. To apply PRP as a conservative treatment option with a demonstrable level of scientific evidence (2b).<\/p>\n<\/div>\n<\/div>\n

        \n
        \n

        Material and Methods: Prospective quasi-experimental before-after study (non-randomized control-trial) on 24 patients with PFPS and Chondromalacia grade 2 or more, who attended to Santa Cristina\u2019s University Hospital, from January 2014 to March 2017. The PRP- protocol consisted of 3-sessions (1 session\/week) of an intra articular infiltration of 3ml of platelet-rich plasma (PRP). To get the PRP, Accelerate Concentration System Device\u00ae from EXACTECH, EmCyte Anticoagulant Sodium Citrate Solution U.S.P. and Drucker Centrifuge (Series Performance) were used. Pain and Quality of Life were measured by Visual Analogical Scale (VAS) and Western Ontario and Mc Master Universities Index for Osteoarthritis (WOMAC) at the beginning \/ end of treatment.<\/p>\n<\/div>\n<\/div>\n

        \n
        \n

        Results: Average age was 40.3\u00b19.5 years. Women 37.5% (n=9), men 62.5% (n=15). The most frequent Chondromalacia grade was 2nd degree (n=11, 45.8%), followed by 3rd (n=9, 37.5%) and 4th (n=4, 16.6%). Post-puncture erythema and inflammation 4.1% (n=1).<\/p>\n<\/div>\n<\/div>\n

        \n
        \n

        Pain measured by VAS significantly decreased (p<0.0001) from 7.87 to 3.04 points. The WOMAC-pain, WOMAC-stiffness and WOMAC- function subscales decreased significantly (p<0.0001) from 15.12 to 5.95 points, 1.95 to 0.5 and 39.75 to 16.37, respectively.<\/p>\n<\/div>\n<\/div>\n

        \n
        \n

        Conclusion: PRP is safe and improves significantly pain relief, stiffness and function in patients with Patellofemoral Pain Syndrome and Chondromalacia.<\/p>\n<\/div>\n<\/div>\n

        \n
        \n

        The study shows a good level of evidence and grade of recommendation that allows us to consider PRP as a conservative therapeutic option in the treatment of PFPS and chondromalacia.<\/p>\n<\/div>\n<\/div>\n

        \n

        Keywords: Patellofemoral pain syndrome; Chondromalacia; Pain; PRP therapy; Quality of life
        \nAbbreviations: PFPS: Patellofemoral Pain Syndrome; W Pain, WOMAC pain. W R<\/p>\n

        12<\/p>\n

        Muscles Ligaments Tendons J. 2015 Jul-Sep; 5(3): 162\u2013166.<\/p>\n

        Published online 2015 Oct 20. doi:\u00a0 10.11138\/mltj\/2015.5.3.162<\/a><\/p>\n

        PMCID: PMC4617215<\/p>\n

        Percutaneous injections of Platelet rich plasma for treatment of intrasubstance meniscal lesions<\/b><\/h1>\n

        Fabian Blanke<\/a>,1 Patrick Vavken<\/a>,2 Maximilian Haenle<\/a>,1 Lutz von Wehren<\/a>,2 Geert Pagenstert<\/a>,2 and Martin Majewski<\/a>2<\/h1>\n

        Author information ? Copyright and License information ?<\/p>\n

        Introduction<\/b><\/p>\n

        management of intrasubstance meniscal lesions is still controversial. Intrasubstance meniscal lesions can lead to reduced sports activity and meniscal rupture. Physical therapy is often not satisfactory. Therefore new treatment methods are requested. Platelet Rich Plasma (PRP) has the ability to regenerate tissue; this was proved in several experimental studies. Whether percutaneous injections of PRP are effective in intrasubstance meniscal lesions is unknown. We hypothesize that percutaneous PRP injections lead to pain relief and halt of progression on MRI over 6 months in patients with grade 2 meniscal lesions.<\/p>\n

        Materials and methods<\/b><\/p>\n

        ten recreational athletes with intrasubstance meniscal lesions (grade II according to Reicher) proven by MR-Imaging (MRI) were treated by percutaneous injections of PRP in the affected meniscal area. Three sequential injections in seven day intervals were performed in every patient. All injections were performed with image converter. Follow-up MRI was done six months after last injection in every patient. Level of sports activity and amount of pain at athletic loads according to numeric rating scale (NRS-11) were noted in each patient before injections and at the time of follow up MRI after six months. The t-test was used to determine statistical differences.<\/p>\n

        Results<\/b><\/p>\n

        four of ten patients (40%) showed decrease of meniscal lesion in follow up MRI after six months. Nine of ten patients (90%) complained about short episodes of heavy pain after the injections with average NRS-Score of 7.9 at daily loads after the last injection. Six of ten patients (60%) showed Improvement of NRS-Score at final follow up. Average NRS-Score improved significantly (p=0.027) from 6.9 before injections to 4.5 six month after treatment. Six of ten patients (60%) reported increase of sports activity compared to the situation before injections. In four patients (40%) additional surgical treatment was necessary because of persistent knee pain or progression of meniscal lesion.<\/p>\n

        Conclusions<\/b><\/p>\n

        percutaneous injections of PRP have the ability to achieve pain relief and halt of progression on MRI over 6 months in patients with grade 2 meniscal lesions. Therefore it could be considered as a treatment option in patients with persisting pain.<\/p>\n

        Level of evidence<\/b><\/p>\n

        IV.<\/p>\n

        \n

        12<\/p>\n

        Acta Cir Bras. 2017;32(10):827-835\u00a0<\/b><\/p>\n

        Biomechanical study of the effect of platelet rich plasma on the treatment of medial collateral ligament lesion in rabbits<\/b>1\u00a0<\/b><\/h1>\n

        Eduardo Louzada da CostaI, Luiz Eduardo Moreira TeixeiraII, Bruno Janno P\u00e1duaIII, Ivana Duval de Ara\u00fajoIV, Leonardo de Souza VasconcellosV, Luide Scalioni Borges DiasVI<\/p>\n

        IMSc, Department of Orthopedics, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte-MG, Brazil. Concep on and design of the study; acquisi on, analysis and interpreta on of data; manuscript wri ng; cri cal revision.
        \nIIPhD, Assistant Professor, Department of Locomo ve Apparatus, UFMG, Belo Horizonte-MG, Brazil. Concep on and design of the study; acquisi on, analysis and interpreta on of data; manuscript wri ng; cri cal revision.<\/p>\n

        IIIMD, Department of Orthopedics, UFMG, Belo Horizonte-MG, Brazil. Acquisi on, analysis and interpreta on of data. IVPhD, Assistant Professor, Department of Surgery, UFMG, Belo Horizonte-MG, Brazil. Concep on and design of the study; acquisi on, analysis and interpreta on of data; manuscript wri ng; cri cal revision.
        \nVPhD, Assistant Professor, Pharmacy Department, UFMG, Belo Horizonte-MG, Brazil. Acquisi on, analysis and interpreta on of data; manuscript wri ng; cri cal revision.<\/p>\n

        VIGraduate student, School of Medicine, UFMG, Belo Horizonte-MG, Brazil. Acquisi on, analysis and interpreta on of data.<\/p>\n

        Abstract\u00a0<\/b><\/p>\n

        Purpose: <\/b>To evaluate the use of platelet-rich plasma in the early stages of healing of trauma c injury of the medial collateral ligament in the knee of rabbits.
        \nMethods: <\/b>Thirty rabbits were subjected to surgical lesion of the medial collateral ligament. Of these, 16 were treated with platelet-rich plasma and 14 with saline (control). A er 3 and 6 weeks of treatment, 50% of the animals from each group were sacri ced, and biomechanical tests were performed on the injured ligament to compare the tensile strength between the two groups.<\/p>\n

        Results: <\/b>Platelet-rich plasma signi cantly increased the tensile strength of the ligament in the groups treated a er3 and 6 weeks. In the group treated with platelet-rich plasma vs. saline, the tensile strength values were 3192.5 \u00b1 189.7 g\/f vs. 2851.1 \u00b1 193.1 g\/f at3 weeks (p = 0.005) and 5915.6 \u00b1 832.0 g\/f vs. 4187.6 \u00b1 512.9 g\/f at 6 weeks (p = 0.0001).<\/p>\n

        Conclusion: <\/b>The use of platelet-rich plasma at the injury site accelerated ligament healing in an animal model, demonstrated by an increase in the tensile strength of the medial collateral ligament.
        \nKey words: <\/b>Medial Collateral Ligament, Knee. Knee Injuries. Rabbits.<\/p>\n

        13<\/p>\n

         <\/p>\n

        Am J Phys Med Rehabil. 2017 Nov 29. doi: 10.1097\/PHM.0000000000000874. [Epub ahead of print]<\/p>\n

        Effects of platelet-rich plasma on pain and muscle strength in patients with knee osteoarthritis.<\/b><\/h1>\n

        Wu YT<\/a>1,2, Hsu KC<\/a>1, Li TY<\/a>1,2, Chang CK<\/a>3, Chen LC<\/a>1.<\/h1>\n

        Author information<\/b><\/p>\n

        Abstract<\/b><\/p>\n

        OBJECTIVE:<\/b><\/p>\n

        No studies comparing the effects of platelet-rich plasma (PRP) injection and placebo injection in bilateral knee osteoarthritis (OA) in the same patient, or discussing muscle strength after PRP injection, have been published.<\/p>\n

        DESIGN:<\/b><\/p>\n

        Twenty patients with bilateral knee OA were eligible, and 40 knees were randomized into two groups: PRP (knees [right or left by a coin toss] receiving a single intra-articular PRP injection) and saline group (the contralateral knee of the same patient, into which single 4-mL intra-articular injection of normal saline was administered). The primary outcome measure was Western Ontario and McMaster’s Universities Osteoarthritis Index (WOMAC) and the secondary included isokinetic test results. The evaluation was at baseline and at 2 weeks, 1, 3, and 6 months post-injection.<\/p>\n

        RESULTS:<\/b><\/p>\n

        The PRP group showed a significant reduction in the WOMAC-pain and -total scores compared to normal saline group (p < 0.05). Although a significantly greater percentage of knee strength (extensor > flexor) was found in the PRP group during a longer follow-up period, PRP treatment resulted in insignificant differences in muscle strength compared to normal saline.<\/p>\n

        CONCLUSIONS:<\/b><\/p>\n

        PRP treatment significantly improves pain, stiffness, and disability in patients with knee OA compared to normal saline treatment. Additional strength training is recommended to enhance muscle strength recovery.<\/p>\n

        PMID: 29210705 DOI: 10.1097\/PHM.0000000000000874<\/a><\/p>\n

        14<\/p>\n

         <\/p>\n

        J Orthop Surg (Hong Kong).<\/a>\u00a02019 May-Aug;27(2):2309499019852779. doi: 10.1177\/2309499019852779.<\/div>\n

        Radiological and functional outcomes of ultrasound-guided\u00a0PRP\u00a0injections in intrasubstance meniscal degenerations.<\/h1>\n
        \u00d6zyalva\u00e7 ON<\/a>1,\u00a0T\u00fcz\u00fcner T<\/a>2,\u00a0G\u00fcrpinar T<\/a>2,\u00a0Obut A<\/a>3,\u00a0Acar B<\/a>2,\u00a0Akman YE<\/a>4.<\/div>\n
        \n

        Author information<\/a><\/h3>\n
        \n
        \n

        Abstract<\/h3>\n
        \n

        AIM:<\/h4>\n

        This retrospective study is aimed to analyze the effect of ultrasound-guided platelet-rich plasma (PRP) injections on grade 2 intrasubstance meniscal degenerations (IMDs).<\/p>\n

        MATERIALS AND METHODS:<\/h4>\n

        Fifteen patients who underwent\u00a0PRP\u00a0injections for symptomatic grade 2 meniscal lesions were included in the study. All injections were performed with ultrasound in the degenerated menisci. Patients were evaluated with Lysholm score and magnetic resonance imaging (MRI) before the injection and after a mean of 32-month follow-up. T2-weighted MRI images were evaluated on sagittal by two authors as double-blind.<\/p>\n

        RESULTS:<\/h4>\n

        Lysholm score was found to be statistically significantly increased, and in 67% of the patients, grade 2 degenerations were improved to grade 1.<\/p>\n

        CONCLUSION:<\/h4>\n

        Intra-meniscal\u00a0PRP\u00a0injection under ultrasonography guidance provides good functional scores and radiological improvement in the patients with IMD.<\/p>\n<\/div>\n<\/div>\n

        \n

        KEYWORDS:<\/h4>\n

        grade 2 meniscal degeneration; intrasubstance meniscal degeneration; platelet-rich plasma (PRP)<\/p>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n

        PRP and Elbow<\/h1>\n

        1.<\/strong><\/p>\n

        Am J Sports Med.<\/a> 2011 Jun;39(6):1200-8. Epub 2011 Mar 21.<\/p>\n

        Ongoing positive effect of\u00a0platelet-rich plasma\u00a0versus corticosteroid injection in lateral epicondylitis: a double-<\/h1>\n

        blind randomized controlled trial with 2-year follow-up.<\/h1>\n

        Abstract<\/h3>\n

        BACKGROUND:<\/h4>\n

        Platelet-rich plasma\u00a0(PRP) has been shown to be a general stimulation for repair and 1-year results showed promising success percentages.<\/p>\n

        PURPOSE:<\/h4>\n

        This trial was undertaken to determine the effectiveness of PRP compared with corticosteroid injections in patients with chronic lateral epicondylitis with a 2-year follow-up.<\/p>\n

        STUDY DESIGN:<\/h4>\n

        Randomized controlled trial; Level of evidence, 1.<\/p>\n

        METHODS:<\/h4>\n

        The trial was conducted in 2 Dutch teaching hospitals. One hundred patients with chronic lateral epicondylitis were randomly assigned to a leukocyte-enriched PRP group (n = 51) or the corticosteroid group (n = 49). Randomization and allocation to the trial group were carried out by a central computer system. Patients received either a corticosteroid injection or an autologous\u00a0platelet\u00a0concentrate injection through a peppering needling technique. The primary analysis included visual analog scale (VAS) pain scores and Disabilities of the Arm,\u00a0Shoulder\u00a0and Hand (DASH) outcome scores.<\/p>\n

        RESULTS:<\/h4>\n

        The PRP group was more often successfully treated than the corticosteroid group (P < .0001). Success was defined as a reduction of 25% on VAS or DASH scores without a reintervention after 2 years. When baseline VAS and DASH scores were compared with the scores at 2-year follow-up, both groups significantly improved across time (intention-to-treat principle). However, the DASH scores of the corticosteroid group returned to baseline levels, while those of the PRP group significantly improved (as-treated principle). There were no complications related to the use of PRP.<\/p>\n

        CONCLUSION:<\/h4>\n

        Treatment of patients with chronic lateral epicondylitis with PRP reduces pain and increases function significantly, exceeding the effect of corticosteroid injection even after a follow-up of 2 years. Future decisions for application of PRP for lateral epicondylitis should be confirmed by further follow-up from this trial and should take into account possible costs and harms as well as benefits.<\/p>\n

         <\/p>\n

        2.\u00a0<\/strong><\/p>\n

        J Orthop.<\/a>\u00a02015 Nov 18;12(Suppl 2):S166-70. doi: 10.1016\/j.jor.2015.10.018. eCollection 2015.<\/div>\n

        The effect of platelet-rich plasma injection on\u00a0lateral epicondylitis\u00a0following failed conservative management.<\/h1>\n
        Brkljac M<\/a>1,\u00a0Kumar S<\/a>2,\u00a0Kalloo D<\/a>2,\u00a0Hirehal K<\/a>2.<\/div>\n
        \n

        Author information<\/a><\/h3>\n
        <\/div>\n<\/div>\n
        \n

        Abstract<\/h3>\n
        \n

        OBJECTIVE:<\/h4>\n

        We assessed the effect\u00a0PRP\u00a0injection on pain and function in patients with\u00a0lateral epicondylitis\u00a0where conservative management had failed.<\/p>\n

        METHODS:<\/h4>\n

        We prospectively reviewed 34 patients. The mean follow-up was 26 weeks (range 6-114 weeks). We used the Oxford\u00a0Elbow\u00a0Score (OES) and progression to surgery to assess outcomes.<\/p>\n

        RESULTS:<\/h4>\n

        88.2% improved their OES. 8.8% reported symptom progression. One patient had no change. No patients suffered adverse reactions. Two patients underwent an open release procedure. One had the injection repeated.<\/p>\n

        CONCLUSION:<\/h4>\n

        An injection of\u00a0PRP\u00a0improves pain and function in patients suffering from LE where conservative management has failed.<\/p>\n<\/div>\n<\/div>\n

        \n

        KEYWORDS:<\/h4>\n

        ASES, American Shoulder and\u00a0Elbow\u00a0Surgeons; AWB, autologous whole blood; DASH, disabilities of arm, shoulder and hand; ECRB, Extensor Carpe Radialis Brevis; LE,\u00a0lateral epicondylitis;\u00a0Lateral epicondylitis;\u00a0Lateral\u00a0tendinosis; MCID, minimal clinically important difference; NSAIDs, non-steroidal anti-inflammatorys; OES, Oxford\u00a0Elbow\u00a0Score;\u00a0PRP, platelet-rich plasma; Platelet-rich plasma;\u00a0Tennis elbow; VAS, visual-analogue score<\/p>\n

         <\/p>\n

        3.<\/strong><\/p>\n

        Rev Bras Ortop.<\/a>\u00a02016 Jan 13;51(1):90-5. doi: 10.1016\/j.rboe.2015.03.014.<\/div>\n

        Effects of platelet-rich plasma on\u00a0lateral epicondylitis\u00a0of the\u00a0elbow: prospective randomized controlled trial.<\/h1>\n
        Palacio EP<\/a>1,\u00a0Schiavetti RR<\/a>1,\u00a0Kanematsu M<\/a>1,\u00a0Ikeda TM<\/a>1,\u00a0Mizobuchi RR<\/a>1,\u00a0Galbiatti JA<\/a>1.<\/div>\n
        \n

        Author information<\/a><\/h3>\n
        <\/div>\n<\/div>\n
        \n

        Abstract<\/h3>\n
        in\u00a0English<\/a>,\u00a0Portuguese<\/a><\/div>\n
        \n

        OBJECTIVE:<\/h4>\n

        To evaluate the effects of platelet-rich plasma (PRP) infiltration in patients with\u00a0lateral epicondylitis\u00a0of the\u00a0elbow, through analysis of the Disabilities of the Arm, Shoulder and Hand (DASH) and Patient-Rated\u00a0Tennis Elbow\u00a0Evaluation (PRTEE) questionnaires.<\/p>\n

        METHODS:<\/h4>\n

        Sixty patients with\u00a0lateral epicondylitis\u00a0of the\u00a0elbow\u00a0were prospectively randomized and evaluated after receiving infiltration of three milliliters of\u00a0PRP, or 0.5% neocaine, or dexamethasone. For the scoring process, the patients were asked to fill out the DASH and PRTEE questionnaires on three occasions: on the day of infiltration and 90 and 180 days afterwards.<\/p>\n

        RESULTS:<\/h4>\n

        Around 81.7% of the patients who underwent the treatment presented some improvement of the symptoms. The statistical tests showed that there was evidence that the cure rate was unrelated to the substance applied (p\u00a0=\u00a00.62). There was also intersection between the confidence intervals of each group, thus demonstrating that the proportions of patients whose symptoms improved were similar in all the groups.<\/p>\n

        CONCLUSION:<\/h4>\n

        At a significance level of 5%, there was no evidence that one treatment was more effective than another, when assessed using the DASH and PRTEE questionnaires.<\/p>\n

         <\/p>\n

        4.<\/strong><\/p>\n

        J Orthop.<\/a>\u00a02016 Jan 22;13(1):10-4. doi: 10.1016\/j.jor.2015.12.005. eCollection 2016.<\/div>\n

        Platelet-rich plasma versus open surgical release in chronic\u00a0tennis elbow: A retrospective comparative study.<\/h1>\n
        Karaduman M<\/a>1,\u00a0Okkaoglu MC<\/a>1,\u00a0Sesen H<\/a>1,\u00a0Taskesen A<\/a>1,\u00a0Ozdemir M<\/a>1,\u00a0Altay M<\/a>1.<\/div>\n
        \n

        Author information<\/a><\/h3>\n
        <\/div>\n<\/div>\n
        \n

        Abstract<\/h3>\n
        \n

        PURPOSE:<\/h4>\n

        To compare short and mid-term results in the treatment of chronic\u00a0elbow\u00a0tendinosis with platelet-rich plasma (PRP) or Nirschl surgical technique.<\/p>\n

        METHOD:<\/h4>\n

        A retrospective study was conducted on patients with chronic\u00a0lateral epicondylitis, treated by Nirschl surgical technique (50 elbows) or\u00a0PRP\u00a0(60 elbows). Outcome was evaluated with Visual Analog Score (VAS), Mayo\u00a0Elbow\u00a0Scores and grip strength measurements.<\/p>\n

        RESULTS:<\/h4>\n

        VAS and Mayo\u00a0Elbow\u00a0Scores of the\u00a0PRP\u00a0group had improved as a mean of 83% (p\u00a0=\u00a00.0001), 74% (p\u00a0=\u00a00.0001) over baseline and 34.2 pounds gain of grip strength.<\/p>\n

        CONCLUSION:<\/h4>\n

        The\u00a0PRP\u00a0seems to be better for pain relief and functionality in the short and mid-term periods.<\/p>\n<\/div>\n<\/div>\n

        \n

        KEYWORDS:<\/h4>\n

        Chronic\u00a0elbow\u00a0tendinosis; Nirschl surgical technique; Platelet rich plasma (PRP)<\/p>\n

         <\/p>\n

        5.<\/strong><\/p>\n

        J Pak Med Assoc.<\/a>\u00a02015 Nov;65(11 Suppl 3):S100-4.<\/div>\n

        Effectiveness of platelets rich plasma versus corticosteroids in\u00a0lateral epicondylitis.<\/h1>\n
        Khaliq A<\/a>1,\u00a0Khan I<\/a>2,\u00a0Inam M<\/a>1,\u00a0Saeed M<\/a>1,\u00a0Khan H<\/a>1,\u00a0Iqbal MJ<\/a>1.<\/div>\n
        \n

        Author information<\/a><\/h3>\n
        <\/div>\n<\/div>\n
        \n

        Abstract<\/h3>\n
        \n

        OBJECTIVE:<\/h4>\n

        To compare the treatment modalities of\u00a0lateral epicondylitis\u00a0in terms of pain relief.<\/p>\n

        METHODS:<\/h4>\n

        The randomised controlled study was conducted at Hayatabad Medical Complex, Peshawar, Pakistan, from April 2013 to March 2014, and comprised cases of\u00a0lateral epicondylitis. The patients were selected through consecutive sampling from the outpatient department and were randomly allocated to two equal groups; group A receiving corticosteroid injections, and group B receiving injection of platelet-rich plasma. The patients were followed up for three weeks to determine the effectiveness of intervention.<\/p>\n

        RESULTS:<\/h4>\n

        The 102 patients in the study were divided into two groups of 51(50%) each. The over mean age was 33.9\u00b110.3 years. Mean age of patients in the corticosteroid group was 34.2\u00b110.2 years and in the other group it was 33.6\u00b110.5 years. Mean baseline visual analogue score in group A were 6.5\u00b11.2 and in group B it was 6.7\u00b11.4. In group A, 74.5% of patients presented in moderate pain category and 25.5% presented in severe pain category. In group B, 70.6% presented in moderate with 29.4% presented in severe pain category. On follow-up, the mean pain score in group A was 4.0\u00b12.6 and in group B it was 3.5\u00b12.61. Group A showed effectiveness in 52.9% patients and group B showed effectiveness in 82.3% (p=0.001).<\/p>\n

        CONCLUSIONS:<\/h4>\n

        PRP\u00a0is an effective alternate to corticosteroid in the treatment of\u00a0lateral epicondylitis\u00a0(tennis elbow).<\/p>\n<\/div>\n<\/div>\n

        \n

        KEYWORDS:<\/h4>\n

        Lateral epicondylitis,\u00a0Tennis elbow, Steroid, Platelet-rich plasma, Visual analogue scale.<\/p>\n

         <\/p>\n

        6.\u00a0<\/strong><\/p>\n

        J Sport Rehabil.<\/a>\u00a02016 Feb;25(1):77-82. doi: 10.1123\/jsr.2014-0198.<\/div>\n

        Platelet-Rich Plasma Compared With Other Common Injection Therapies in the Treatment of Chronic\u00a0Lateral Epicondylitis.<\/h1>\n
        Rodik T<\/a>1,\u00a0McDermott B<\/a>.<\/div>\n
        \n

        Author information<\/a><\/h3>\n
        <\/div>\n<\/div>\n
        \n

        Abstract<\/h3>\n
        \n

        CLINICAL SCENARIO:<\/h4>\n

        Lateral epicondylitis\u00a0(LE) is a relatively common pathology capable of producing chronic debilitation in a variety of patients. A newer treatment for orthopedic conditions is platelet-rich plasma (PrP) local injection. Focused Clinical Question: Is\u00a0PrP\u00a0a more appropriate injection therapy for LE than other common injections such as corticosteroid or whole blood? Summary of Key Findings: Four studies were included: 1 randomized controlled trial (RCT), 2 double-blind RCTs, and 1 cohort study. Two studies involved comparisons of\u00a0PrP\u00a0injection to corticosteroid injection. One of the studies involved a 2-y follow-up while another involved a 1-y follow-up. Another study involved the comparison of\u00a0PrP\u00a0injection with whole-blood injection with a 6-mo follow-up. The final study included a\u00a0PrP-injection group and control group. The 2 studies involving\u00a0PrP\u00a0vs corticosteroid injections with 2-y and 1-y follow-ups both favored\u00a0PrP\u00a0over corticosteroid injection in terms of pain reduction and function increases. The third study favored\u00a0PrP\u00a0injections over whole-blood injections at 6 mo regarding pain reduction. All studies demonstrated significant improvements with\u00a0PrP\u00a0over comparison injections or no injection. Clinical Bottom Line:\u00a0PrP\u00a0injections provide more favorable pain and function outcomes than whole blood and corticosteroid injections for 1-2 y after injection.<\/p>\n

        STRENGTH OF RECOMMENDATION:<\/h4>\n

        Consistent findings from RCTs suggest level 1b evidence in support of\u00a0PrP\u00a0injection as a treatment for LE.<\/p>\n

         <\/p>\n

        7.<\/strong><\/p>\n

        J Hand Microsurg.<\/a>\u00a02015 Dec;7(2):320-5. doi: 10.1007\/s12593-015-0193-3. Epub 2015 Jul 8.<\/div>\n

        Platelet-Rich-Plasma Injections in Treating\u00a0Lateral\u00a0Epicondylosis: a Review of the Recent Evidence.<\/h1>\n
        Murray DJ<\/a>1,\u00a0Javed S<\/a>2,\u00a0Jain N<\/a>1,\u00a0Kemp S<\/a>1,\u00a0Watts AC<\/a>1.<\/div>\n
        \n

        Author information<\/a><\/h3>\n
        <\/div>\n<\/div>\n
        \n

        Abstract<\/h3>\n
        \n

        Lateral\u00a0epicondylosis is common, with various treatment modalities. Platelet-rich-plasma injections from autologous blood have recently been used in centres worldwide for the treatment of\u00a0tennis elbow. We review and present the recent published evidence on the effectiveness of\u00a0PRP\u00a0injections for\u00a0lateral\u00a0epicondylosis. Nine studies met our inclusion criteria including 6 RCT’s for the purpose of analysis.\u00a0PRP\u00a0injections have an important and effective role in the treatment of this debilitating pathology, in cases where physiotherapy has been unsuccessful.<\/p>\n<\/div>\n<\/div>\n

        \n

        KEYWORDS:<\/h4>\n

        Lateral epicondylitis;\u00a0Lateral\u00a0epicondylosis;\u00a0PRP; Platelet\u2014Rich\u2014Plasma;\u00a0Tennis elbow<\/p>\n

         <\/p>\n

        8.<\/strong><\/p>\n

         <\/p>\n

        J Clin Diagn Res.<\/a>\u00a02015 Jul;9(7):RC05-7. doi: 10.7860\/JCDR\/2015\/14087.6213. Epub 2015 Jul 1.<\/div>\n

        Comparison of Local Injection of Platelet Rich Plasma and Corticosteroids in the Treatment of\u00a0Lateral Epicondylitis\u00a0of Humerus.<\/h1>\n
        Yadav R<\/a>1,\u00a0Kothari SY<\/a>2,\u00a0Borah D<\/a>3.<\/div>\n
        \n

        Author information<\/a><\/h3>\n
        <\/div>\n<\/div>\n
        \n

        Abstract<\/h3>\n
        \n

        INTRODUCTION:<\/h4>\n

        Lateral epicondylitis\u00a0or\u00a0Tennis Elbow\u00a0is one of the most common causes of upper extremity pain with various treatment options. Platelet-rich plasma (PRP) offers a new option for the treatment of\u00a0lateral epicondylitis. This study was conducted with an aim to compare the efficacy of\u00a0PRP\u00a0versus methyl-prednisolone local injection in patients with\u00a0lateral epicondylitis.<\/p>\n

        MATERIALS AND METHODS:<\/h4>\n

        Sixty five patients with\u00a0lateral epicondylitis\u00a0were included in the study and randomized into two groups. Group A was treated with single injection of 1ml\u00a0PRP\u00a0with absolute platelet count of at least 1 million platelets\/ mm(3). Group B was treated with single injection of 1ml (40mg) methyl-prednisolone. Pain, grip strength and functional improvements were assessed using visual analogue scale, dynamometer and quick Disabilities of the Arm, Shoulder and Hand scale respectively at baseline, 15 days, 1 month and 3 months.<\/p>\n

        RESULTS:<\/h4>\n

        Sixty patients completed the follow up. All assessment parameters improved significantly in both the Groups at each follow up compared to baseline. At the end of three months group A showed significantly better improvement as compared to Group B.<\/p>\n

        CONCLUSION:<\/h4>\n

        PRP\u00a0and methyl-prenisolone both are effective in the treatment of\u00a0lateral epicondylitis. However,\u00a0PRP\u00a0is a superior treatment option for longer duration efficacy.<\/p>\n<\/div>\n<\/div>\n

        \n

        KEYWORDS:<\/h4>\n

        Methyl-prednisolone; Musculoskeletal pain;\u00a0Tennis elbow<\/p>\n

         <\/p>\n

        9.<\/p>\n

        Arthroscopy.<\/a>\u00a02017 Apr 19. pii: S0749-8063(17)30176-7. doi: 10.1016\/j.arthro.2017.02.009. [Epub ahead of print]<\/div>\n

        Arthroscopic Debridement Versus Platelet-Rich Plasma Injection: A Prospective, Randomized, Comparative Study of Chronic\u00a0Lateral Epicondylitis\u00a0With a Nearly 2-Year Follow-Up.<\/h1>\n
        Merolla G<\/a>1,\u00a0Dellabiancia F<\/a>2,\u00a0Ricci A<\/a>3,\u00a0Mussoni MP<\/a>4,\u00a0Nucci S<\/a>4,\u00a0Zanoli G<\/a>5,\u00a0Paladini P<\/a>3,\u00a0Porcellini G<\/a>3.<\/div>\n
        \n

        Author information<\/a><\/h3>\n
        <\/div>\n<\/div>\n
        \n

        Abstract<\/h3>\n
        \n

        PURPOSE:<\/h4>\n

        The purpose of this prospective, randomized study was to compare the efficacy of autologous platelet-rich\u00a0plasma (PRP) injections and arthroscopic\u00a0lateral\u00a0release in treating chronic\u00a0lateral epicondylitis\u00a0(LE).<\/p>\n

        METHODS:<\/h4>\n

        Patients who had a clinical diagnosis of LE confirmed by ultrasound (US) were included in this study. A total of 101 patients received arthroscopic release (n\u00a0= 50) or US-guided\u00a0PRP\u00a0injections (n\u00a0= 51). Outcomes were assessed using a visual analog scale for pain, the Patient-Rated\u00a0Tennis Elbow\u00a0Evaluation (PRTEE), and a calibrated hand dynamometer for grip strength.<\/p>\n

        RESULTS:<\/h4>\n

        Both patient groups experienced significant improvement in all measures. Between-group comparisons showed a significantly higher value in the\u00a0PRP\u00a0group only for grip strength at week 8 (P\u00a0= .0073); all other significant differences were in favor of arthroscopy: overall pain (P\u00a0= .0021), night pain (P\u00a0= .0013), and PRTEE score (P\u00a0=\u00a0.0013) at week 104 and grip strength at weeks 24, 52, and 104 (all P < .0001). Consumption of rescue pain medication was not significantly different between the groups.<\/p>\n

        CONCLUSIONS:<\/h4>\n

        The present findings suggest that (1)\u00a0PRP\u00a0injections and arthroscopic extensor carpi radialis brevis release are both effective in the short and medium term; (2)\u00a0PRP\u00a0patients experienced a significant worsening of pain at 2\u00a0years; (3) arthroscopic release ensured better long-term outcomes in terms of pain relief and grip strength recovery; and (4) both procedures were safe and well accepted by patients. LEVEL\u00a0OF EVIDENCE: Level II, prospective comparative study.<\/p>\n

        Copyright \u00a9 2017 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.<\/p>\n

         <\/p>\n

         <\/p>\n<\/div>\n<\/div>\n

        PRP and the Shoulder<\/h1>\n

        1.<\/p>\n

        PLoS One.<\/a>\u00a02016 Feb 5;11(2):e0147842. doi: 10.1371\/journal.pone.0147842. eCollection 2016.<\/div>\n

        A Pilot Study Evaluating the Effectiveness of Platelet-Rich Plasma Therapy for Treating Degenerative Tendinopathies: A Randomized Control Trial with Synchronous Observational Cohort.<\/h1>\n
        Wesner M<\/a>1,\u00a0Defreitas T<\/a>1,\u00a0Bredy H<\/a>1,2,\u00a0Pothier L<\/a>1,\u00a0Qin Z<\/a>3,\u00a0McKillop AB<\/a>3,\u00a0Gross DP<\/a>1,2,3.<\/div>\n
        \n

        Author information<\/a><\/h3>\n
        <\/div>\n<\/div>\n
        \n

        Abstract<\/h3>\n
        \n

        OBJECTIVE:<\/h4>\n

        This pilot study aimed to inform future research evaluating the effectiveness of Platelet Rich Plasma (PRP) injection for tendinopathy.<\/p>\n

        DESIGN:<\/h4>\n

        Randomized control trial (RCT) and synchronous observational cohort studies. For the RCT, consecutive consenting patients treated at an academic sports medicine clinic were randomly assigned to either a\u00a0PRP\u00a0or placebo control group.<\/p>\n

        SETTING:<\/h4>\n

        The Glen Sather Sport Medicine Clinic, Edmonton, Canada.<\/p>\n

        PATIENTS:<\/h4>\n

        The RCT included 9 participants with\u00a0rotator cuff\u00a0tendinopathy. The cohort study included 178 participants with a variety of tendinopathies.<\/p>\n

        INTERVENTIONS:<\/h4>\n

        Patients receiving\u00a0PRP\u00a0were injected with 4 ml of platelets into the supraspinatus and\/or infraspinatus, while patients in the placebo group were injected with 4ml of saline. All participants undertook a 3-month standardized, home-based, daily exercise program.<\/p>\n

        MAIN OUTCOME MEASURES:<\/h4>\n

        Participants in the RCT were re-evaluated 3, and 6 months post-injection. Change scores before and after injection on pain, disability and MRI-documented pathology outcomes were compared. In the cohort study, pain and disability were measured at 1, 2 and 3 months post-injection.<\/p>\n

        RESULTS:<\/h4>\n

        For the RCT, 7 participants received\u00a0PRP\u00a0and 2 received placebo injections. Patients receiving\u00a0PRP\u00a0reported clinically important improvements in pain (>1.5\/10 on VAS), disability (>15 point DASH change), and tendon pathology while those receiving placebo injections did not. In the observational cohort, statistically and clinically significant improvements in pain and disability were observed.<\/p>\n

        CONCLUSION:<\/h4>\n

        This pilot study provides information for planning future studies of\u00a0PRP\u00a0effectiveness. Preliminary results indicate intratendinous, ultrasound-guided\u00a0PRP\u00a0injection may lead to improvements in pain, function, and MRI-documented tendon pathology.<\/p>\n

        TRIAL REGISTRATION:<\/h4>\n

        Controlled-Trials.com ISRCTN68341698.<\/p>\n<\/div>\n<\/div>\n

         <\/p>\n

        Orthop Traumatol Surg Res.<\/a>\u00a02016 Feb;102(1):47-52. doi: 10.1016\/j.otsr.2015.11.002. Epub 2016 Jan 7.<\/div>\n
        <\/div>\n
        2.<\/div>\n
        \n
        Eur J Orthop Surg Traumatol.<\/a>\u00a02016 Dec;26(8):837-842. Epub 2016 Aug 20.<\/div>\n

        Subacromial injection of autologous platelet-rich plasma versus corticosteroid for the treatment of symptomatic partial rotator cuff tears.<\/h1>\n
        Shams A<\/a>1,\u00a0El-Sayed M<\/a>2,\u00a0Gamal O<\/a>1,\u00a0Ewes W<\/a>3.<\/div>\n
        \n

        Author information<\/a><\/h3>\n
        <\/div>\n<\/div>\n
        \n

        Abstract<\/h3>\n
        \n

        OBJECTIVE:<\/h4>\n

        Rotator cuff tears are one of the most common causes of chronic\u00a0shoulder pain\u00a0and disability. They significantly affect the quality of life. Reduced\u00a0pain\u00a0and improved function are the goals of conventional therapy, which includes relative rest,\u00a0pain\u00a0therapy, physical therapy, corticosteroid injections and surgical intervention. Tendons have a relative avascular nature; hence, their regenerative potential is limited. There is some clinical evidence that the application of autologous platelets may help to revascularize the area of injury in rotator cuff pathologies.<\/p>\n

        PATIENTS AND METHODS:<\/h4>\n

        This prospective randomized controlled study was done to evaluate the results of subacromial injection of platelet-rich plasma (PRP) versus corticosteroid injection therapy in 40 patients with symptomatic partial rotator cuff tears. All patients were assessed before injection, 6\u00a0weeks, 3 and 6\u00a0months after injection, using the American\u00a0Shoulder\u00a0and Elbow Surgeons Standardized\u00a0Shoulder\u00a0Assessment Form (ASES), the Constant-Murley Score (CMS), the Simple\u00a0Shoulder\u00a0Test (SST) and a Visual Analog Scale (VAS) for\u00a0pain. An MRI was performed before and 6\u00a0months after the injection for all the included patients and was graded on 0-5 scale.<\/p>\n

        RESULTS:<\/h4>\n

        Both injection groups showed statistically significantly better clinical outcomes over time compared with those before injection. There was a statistically significant difference between RPP group and corticosteroid group 12\u00a0weeks after injection, regarding VAS, ASES, CMS and SST in favor of the RPP group. MRI showed an overall slight nonsignificant improvement in grades of tendinopathy\/tear in both groups, however, without statistically significant differences between the two groups.<\/p>\n

        CONCLUSION:<\/h4>\n

        PRP\u00a0injections showed earlier better results as compared to corticosteroid injections, although statistically significant better results after 6\u00a0months could not be found. Therefore, subacromial RPP injection could be considered as a good alternative to corticosteroid injection, especially in patients with a contraindication to corticosteroid administration.<\/p>\n

        LEVEL OF EVIDENCE:<\/h4>\n

        II.<\/p>\n<\/div>\n<\/div>\n

        \n

        KEYWORDS:<\/h4>\n

        Corticosteroid; Platelet-rich plasma; Rotator cuff;\u00a0Shoulder pain; Subacromial impingement syndrome<\/p>\n

        3.<\/p>\n

        Adv Biomed Res.<\/a>\u00a02016 Dec 27;5:200. doi: 10.4103\/2277-9175.190939. eCollection 2016.<\/div>\n

        Ultrasound guided platelet-rich plasma injection for the treatment of rotator cuff tendinopathy.<\/h1>\n
        Tahririan MA<\/a>1,\u00a0Moezi M<\/a>1,\u00a0Motififard M<\/a>1,\u00a0Nemati M<\/a>2,\u00a0Nemati A<\/a>3.<\/div>\n
        \n

        Author information<\/a><\/h3>\n
        <\/div>\n<\/div>\n
        \n

        Abstract<\/h3>\n
        \n

        BACKGROUND:<\/h4>\n

        Degenerative changes and inflammation in the rotator cuff (RC) are the most important causes of\u00a0shoulder pain. The aim of the present study was to determine the effectiveness of platelet-rich plasma (PRP) in patients with chronic RC tendinopathy.<\/p>\n

        MATERIALS AND METHODS:<\/h4>\n

        This study was an open-label study performed at Kashani Hospital between April 2012 and June 2014. Patients with a <1 cm partial tearing of the bursal side of RC with no or little response to conservative management were included.\u00a0PRPinjection was done using ultrasonography guide via posterior subacromial approach. Demographic data were obtained in all patient before the study, and\u00a0shoulder\u00a0function was evaluated using Constant\u00a0shoulder\u00a0score (CSS) before and 3 months after\u00a0PRP\u00a0injection.<\/p>\n

        RESULTS:<\/h4>\n

        A total number of 17 patients were enrolled. The mean of CSS before and after intervention was 37.05 \u00b1 11.03 and 61.76 \u00b1 14.75, respectively (P<\/i>\u00a0< 0.001). There was no statistically significant correlation between the\u00a0pain\u00a0score before the study and the improvement in CSS (P<\/i>\u00a0= 0.45,\u00a0r<\/i>\u00a0= 0.03). Significant relation was observed between the individuals’ age and improvement of CSS (P<\/i>\u00a0= 0.02,\u00a0r<\/i>\u00a0= -0.49). There was no significant difference in CSS improvement between genders (P<\/i>\u00a0= 0.23).<\/p>\n

        CONCLUSION:<\/h4>\n

        Single injection of\u00a0PRP\u00a0is effective to reduce\u00a0pain\u00a0and improve range of motion in patients with bursal side partial tearing of RC who failed to respond to conservative treatments.<\/p>\n<\/div>\n<\/div>\n

        \n

        KEYWORDS:<\/h4>\n

        Constant\u00a0shoulder\u00a0score; platelet-rich plasma; rotator cuff; tendinopathy<\/p>\n<\/div>\n<\/div>\n

        4.<\/div>\n
        \n

        Abstracts from the 2nd International Scientific Tendinopathy Symposium (Vancouver, 2012)<\/p>\n

        USE OF PLATELET RICH PLASMA FOR THE TREATMENT OF BICIPITAL TENDINOPATHY IN SPINAL CORD INJURY: A PILOT STUDY<\/b><\/h1>\n

        V M Ibrahim1,2?, S L Groah1,2, A Libin1,2, I H Ljungberg1,2, D Aufiero1,2, K Patel1,2, S Sampson.1,2<\/p>\n

        Author affiliations<\/p>\n

         <\/p>\n

        Abstract<\/b><\/p>\n

        Introduction Shoulder pain remains one of the most common complaints in the spinal cord injury (SCI) population. Several studies suggest that approximately 30\u201370% of people with SCI in the USA suffer from a debilitating level of shoulder pain. Often this pain is a consequence of shoulder tendinopathy resulting in impingement syndromes. Current treatment strategies include both non-operative and operative strategies, both of which have significant limitations. Given the importance for shoulder health in paraplegics using manual wheelchairs with increasing life expectancy, alternative treatments for shoulder pathology are needed.<\/b><\/p>\n

        Recently biologic medicine has gained popularity to address non-healing wounds and soft tissue injuries. Preliminary data suggests Platelet Rich Plasma (PRP) as a promising alternative treatment option for recalcitrant tendinopathies. Both in-vitro and clinical studies have demonstrated the safety and efficacy of PRP in the treatment of various tendinopathies, most notably in lateral epicondylitis. PRP contains powerful growth factors that initiate wound healing, including platelet derived growth factor, vascular endothelial growth factor, and epithelial growth factor. PRP has demonstrated accelerated bone graft formation in mandibular surgeries, improved fusion rates in spine surgery, and increased efficacy of knee and ankle surgeries. Emerging studies are now exploring the potential use of PRP in operative rotator cuff repair. Non-operative PRP studies have shown positive results in the treatment of lateral epicondylitis, infra-patellar tendonitis, and knee osteoarthritis.<\/b><\/p>\n

        Methods This novel pilot study was designed to explore the efficacy of PRP injections in the wheelchair population with biceps tendon pathology. Validated study outcomes included the Ultrasound Shoulder Pathology Rating Scale (USPRS), the Physical Examination of the Shoulder Scale (PESS) and the Visual Analogue Scale (VAS). Spinal cord injury athletes with chronic shoulder pain were recruited for this study. Members of the tetraplegic rugby and the wheelchair basketball teams at the National Rehabilitation Hospital were specifically targeted for recruitment because of the high prevalence (50%) of bicipital tendinopathy in this population. Participants in the study demonstrated AIS scores of A-D for at least 1?year, shoulder pain for at least 6?months and require the use of a manual wheelchair for the preceding year. Each participant enrolled underwent baseline analysis including USPRS, PESS, VAS and functional scores. Participants then underwent a unilateral biceps tendon sheath injection of PRP and were followed every 2?weeks to monitor VAS scores and adverse events. The study was concluded with an 8?week follow up evaluation. The hypothesis was that an ultrasound guided tendon sheath PRP injection would result in a significant change in USPRS, PESS and VAS scores over the course of the 8-week study period.<\/b><\/p>\n

        Results The study analysis includes eight participants who have completed the full course of treatment and analysis. Comparison of baseline and 8?week data using a non-parametric Wilcoxon Signed Ranks Test demonstrated significant change in the non-injected shoulder on USPRS score (Z=2.207, p=0.027) in PESS score (Z=2.120, p=0.034)) and in the VAS-pain score (Z=2.041, p=0.41). Repeated measure General Linear Model analysis revealed statistically significant trends in the change of pain score measured via VAS at five time points (0, 2, 4, 6, and 8?weeks) for injected arm (F=6.68, p=0.061) but not for the untreated arm. No adverse reactions were reported during the study period.<\/b><\/p>\n

        Discussion The initial pilot data from this study demonstrates a significant effect of PRP using relevant and standardised measures compared to the opposite extremity as a control. While the study sample is admittedly small, a non-parametric analysis demonstrates convincing data on the overall positive effect of PRP in the treatment of biceps tendinopathy in the spinal cord injury population. Given the study results, further investigation is warranted including a randomised control trial.<\/b><\/p>\n

        5. \u00a0 \u00a0\u00a0Am J Phys Med Rehabil \u00a0\u00a0<\/span>2019 Jul;98(7):549-557.<\/span><\/p>\n

        \n
        \n
        doi: 10.1097\/PHM.0000000000001144.<\/span><\/div>\n

        Single Intra-articular Platelet-Rich Plasma Versus Corticosteroid Injections in the Treatment of Adhesive Capsulitis of the Shoulder: A Cohort Study<\/h1>\n
        \n
        \n
        Apurba Barman<\/a>\u00a0<\/span>1<\/a><\/sup>,\u00a0<\/span><\/span>Somnath Mukherjee<\/a>,\u00a0<\/span><\/span>Jagannatha Sahoo<\/a>,\u00a0<\/span><\/span>Rituparna Maiti<\/a>,\u00a0<\/span><\/span>Parnandi Bhaskar Rao<\/a>,\u00a0<\/span><\/span>Mithilesh Kumar Sinha<\/a>,\u00a0<\/span><\/span>Dibyajyoti Sahoo<\/a>,\u00a0<\/span><\/span>Sujit Kumar Tripathy<\/a>,\u00a0<\/span><\/span>Binod Kumar Patro<\/a>,\u00a0<\/span><\/span>Nerbadyswari Deep Bag<\/a><\/span><\/div>\n<\/div>\n<\/div>\n
        Affiliations